Advances in medical technology and knowledge, coupled with political and social change, have precipitated a number of ethical dilemmas in nursing practice. In particular, the issue of whether competent, terminally ill adults should be able to seek a physician's assistance with dying (PAD) is a matter of heated debate among both health professionals and the general public. Given the morbidity and mortality associated with a cancer diagnosis, people with cancer have been identified as a group that may request PAD. Thus, the purpose of this study was to describe the concerns of oncology nurses who care for terminally ill adults who request PAD. To date, most of the research on PAD focuses on quantitative analyses of health care professionals' attitudes concerning acceptability of the practice. A sample of 1,210 randomly selected members of the Oncology Nursing Society completed the Nurses' Attitudes Regarding Physician Assisted Dying Questionnaire. This instrument contained 4 ethical vignettes, each outlining a different scenario in which a dying patient requested PAD. Respondents selected 1 of 4 possible responses that best reflected the decision the nurse would make; respondents also offered narrative comments and stories regarding their choices, opinions, and experiences with PAD. This study represents a content analysis of 369 randomly selected questionnaires containing such narratives. Data were coded and categorized using inductive techniques (Strauss, 1987; Strauss & Corbin, 1990). Mutually exclusive categories and dimensions within categories were identified. Each dimension was labeled as a property within each category according to the manifest meaning of the respondents' comments. All data were independently coded by both investigators; differences were resolved via a third reviewer. Several themes emerged from the data analysis. A key issue involved the nurses' need to know in-depth details and background about the patients in the ethical vignettes. Many offered specific criteria requisite for participation in PAD, most of which paralleled the elements of informed consent. Other criteria included the need to exhaust all other means of relieving suffering prior to agreeing to support the patients' request for PAD. Many reported conflicted feelings about the scenarios presented, and questioned whether PAD has a place in the nursing practice domain. Clearly, attitudes about PAD and ethical reasoning processes regarding the vignettes varied greatly among respondents. Yet, the nursing tenet of "do not abandon" the patient was especially prominent, regardless of the respondents' personal beliefs about acceptability of PAD.

Repository Posting Date:

27-Oct-2011

Date of Publication:

27-Oct-2011

Conference Host:

Southern Nursing Research Society

Note:

This is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.

Advances in medical technology and knowledge, coupled with political and social change, have precipitated a number of ethical dilemmas in nursing practice. In particular, the issue of whether competent, terminally ill adults should be able to seek a physician's assistance with dying (PAD) is a matter of heated debate among both health professionals and the general public. Given the morbidity and mortality associated with a cancer diagnosis, people with cancer have been identified as a group that may request PAD. Thus, the purpose of this study was to describe the concerns of oncology nurses who care for terminally ill adults who request PAD. To date, most of the research on PAD focuses on quantitative analyses of health care professionals' attitudes concerning acceptability of the practice. A sample of 1,210 randomly selected members of the Oncology Nursing Society completed the Nurses' Attitudes Regarding Physician Assisted Dying Questionnaire. This instrument contained 4 ethical vignettes, each outlining a different scenario in which a dying patient requested PAD. Respondents selected 1 of 4 possible responses that best reflected the decision the nurse would make; respondents also offered narrative comments and stories regarding their choices, opinions, and experiences with PAD. This study represents a content analysis of 369 randomly selected questionnaires containing such narratives. Data were coded and categorized using inductive techniques (Strauss, 1987; Strauss & Corbin, 1990). Mutually exclusive categories and dimensions within categories were identified. Each dimension was labeled as a property within each category according to the manifest meaning of the respondents' comments. All data were independently coded by both investigators; differences were resolved via a third reviewer. Several themes emerged from the data analysis. A key issue involved the nurses' need to know in-depth details and background about the patients in the ethical vignettes. Many offered specific criteria requisite for participation in PAD, most of which paralleled the elements of informed consent. Other criteria included the need to exhaust all other means of relieving suffering prior to agreeing to support the patients' request for PAD. Many reported conflicted feelings about the scenarios presented, and questioned whether PAD has a place in the nursing practice domain. Clearly, attitudes about PAD and ethical reasoning processes regarding the vignettes varied greatly among respondents. Yet, the nursing tenet of "do not abandon" the patient was especially prominent, regardless of the respondents' personal beliefs about acceptability of PAD.

en_GB

dc.date.available

2011-10-27T14:43:55Z

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dc.date.issued

2011-10-27

en_GB

dc.date.accessioned

2011-10-27T14:43:55Z

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dc.conference.host

Southern Nursing Research Society

en_US

dc.description.note

This is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.

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